In-person group drama therapy has been associated with increased meaning in life, self-acceptance, and personal growth, as well as with lowered depressive symptoms in older adults. However, little is known about how older adults experience these interventions when delivered through digital platforms or the specific meanings they may have for older women. This qualitative study examined the experiences of older women, drama therapists, and community coordinators in a 12-week tele-drama therapy group for older adults with constricted life-space mobility. The intervention was delivered via Uniper Care, an online social platform designed to promote active aging through accessible and user-friendly technology. To enhance the credibility of the findings, data triangulation was employed using semistructured interviews. Recall interviews were conducted with 20 group members while they viewed selected video segments of their sessions, three drama therapists, and two Uniper Care community coordinators. The thematic analysis yielded four main themes: (a) dramatic play as a novel experience that fosters personal growth, (b) the role of dramatic play in promoting social connectedness, (c) key factors in creating a supportive environment in group tele-drama therapy, and (d) challenges in tele-drama therapy. The findings indicated that core features of drama therapy were present in the online setting, including engagement in dramatic reality, playfulness, shared experience, witnessing, and symbolic and embodied expression. Overall, adapting drama-based interventions to digital platforms can support the psychological and social well-being of older women at home.

BackgroundThe creative arts therapies (CATs) enhance mental health and support cognitive functioning in older age. However, there remains a gap in research regarding their utilisation and older adults' attitudes towards participation.AimsThis study explored older Israeli adults' perceived barriers and facilitators to engaging in CATs, among individuals with and without prior experience.MethodsSemi-structured interviews were conducted with 20 older adults: 10 who had participated in CATs, mostly in art therapy, and 10 who had not. This design enabled a deeper exploration of engagement, with non-participants providing insights into barriers.ResultsA thematic analysis yielded five themes: (1) Preconceptions about mental health services and CATs can act as barriers to utilisation; (2) Referrals and prior familiarity facilitate utilisation; (3) CATs are perceived as less threatening than other forms of mental health services; (4) CATs provide an opportunity to rectify past experiences of self-criticism and oppression related to artistic expression; (5) CATs facilitate a process of self-discovery. Cultural, gender, and migration influences may also shape attitudes toward CATs.ConclusionsThe barriers include mental health stigma, self-stigmatisation of artistic abilities, lack of awareness of CATs, and inadequate referrals. Facilitators include previous art experience, the less intimidating nature of CATs, and the increased self-confidence and personal growth resulting from participation. Cultural sensitivity is essential, since norms and values may shape engagement with CATs.Implications for practiceIdentifying barriers and facilitators to CATs is crucial, for promoting their utilization among older adults. These findings are primarily applicable to art therapy, and further research is needed to explore their relevance to other CATs modalities.Plain-language summaryThe creative arts therapies (CATs), which cover art, drama, music, and dance movement therapies, have been shown to improve mental health and well-being in older adults. However, little is known about older adults ' attitudes towards CATs and the barriers and facilitators influencing their engagement. This study explored these attitudes and identified ways to increase older Israeli adults' participation in CATs. We interviewed 20 older adults, 10 of whom had participated in CATs, mostly in visual art therapy, and 10 who had not, to provide insights into the barriers to participation. Five key findings were identified. Preconceptions about mental health services and misconceptions about CATs, such as the belief that they require artistic skill, discourage participation. Previous exposure to CATs or personal recommendations encourage engagement. CATs are seen as less intimidating than traditional talk therapy, making them more approachable. CATs help older adults overcome struggles with self-criticism and develop confidence in their creative abilities. CATs provide opportunities for self-expression and personal growth. Cultural, gender, and migration influences may also shape attitudes toward CATs. These findings highlight the need to reduce stigma, increase awareness of CATs, and make them more accessible. By addressing these barriers and building on factors that encourage participation, CATs can become a powerful tool to support mental health and enhance well-being in older adults.

The intersection of ageism and homophobia places older gay men in a uniquely vulnerable position, exposing them to compounded forms of discrimination. This intersectionality can manifest in internalized homophobia, limited access to social support, and overall reduced well-being. Psychodrama and drama therapy have proven effective in fostering self-acceptance, strengthening social connections, and supporting identity development in both older adults and LGBT+ individuals. This paper introduces a five-stage tele-drama-based intervention tailored to address the psychological needs of older gay men. The intervention comprises 10 structured sessions to help participants explore their life stories, integrate these experiences into a cohesive narrative, and cultivate a sense of continuity and purpose. Grounded in a conceptual framework of life-span developmental psychology and life review, psychodrama, drama therapy, this paper describes each phase and offers a user's manual-type approach suitable for practice and research. Implementing key processes and techniques is illustrated through case illustrations that highlight the intervention's practical application. Finally, directions for further research are discussed.

Drama therapy is a mental health profession that aims to promote well-being by systematically using dramatic tools and techniques, such as storytelling, dramatic improvisation, and role-play. Research on drama therapy demonstrates its effectiveness in enhancing the mental health and well-being of older adults. Ensuring access to such interventions for older adults with constricted life-space mobility is particularly important, as they are at greater risk for social isolation and poor psychological well-being. The current mixed-methods, randomized controlled trial (RCT), aimed to explore the transition to group tele-drama therapy for older adults with constricted life-space mobility. The quantitative arm of the study examined the impact of a 12-week tele-drama therapy intervention on mental health indices, and the relationship between in-session change factors and changes in outcome measures. The qualitative arm of the study explored the experiences of participants, drama therapists and community coordinators. A total of 111 older adults (aged 63-102) with constricted life-space mobility were randomly assigned to treatment or control groups. The intervention, integrating life review therapy and drama therapy techniques, was delivered via Uniper Care, a social platform with accessible technology designed for the aging population. Findings revealed a significant Time X Group interaction, demonstrating the intervention’s efficacy in reducing depressive symptoms and enhancing social connectedness, well-being, and personal growth. Thematic analysis of semi-structured interviews helped account for these quantitative findings, offering insights into treatment acceptability. These findings point to tele-drama therapy as an effective intervention for older adults with constricted life-space mobility, with implications for broader implementation.

In recent years, fine arts education has shifted toward socially engaged practices-moving beyond the studio to embrace art as a vehicle for social transformation. This turn toward participatory and community-based approaches has also begun to influence creative arts therapies (CATs), where increasing attention is being given to the social dimensions of therapeutic artmaking. Within this context, Social Arts (SA) have emerged as a subfield of participatory arts involving collaboration between socially engaged professionals and non-professionals. Through co-creative processes, SA promotes personal growth, social inclusion, and collective change. Despite growing interest, research on integrating SA into CATs remains limited. This qualitative study investigated SA within CATs Israeli curricula by analyzing course structures, content, and methodologies. Data were collected through semi-structured interviews with eight SA teachers and 14 SA students, alongside a review of SA syllabi. To ensure credibility, the study used triangulation across datasets and member-checking to reduce confirmation bias and verify interpretations. Three main themes emerged: (1) teachers' search for meaning as a driving force, (2) training students to become agents of social change, and (3) challenges in SA training courses. These findings illustrate how SA is being embedded into CATs Master's programs in Israel, offering a unique merger of therapeutic practice and social activism. Further research should explore a broader range of international CATs programs that include SA components, evaluating their impact. Additionally, developing standardized tools to measure SA's multifaceted effects could support their recognition and integration not only within CATs education and practice but also across related disciplines.

BACKGROUND:Approximately one in seven 10 to 19-year-olds cope with mental health conditions globally, which amounts to 13% of the overall burden of disease within this specific age demographic, and the prevalence is expected to rise. Neglecting the management of mental health conditions during adolescence has repercussions into adulthood that adversely affect both physical and mental well-being, and constrain opportunities for leading fulfilling lives. MAIN BODY:This integrative article introduces a new empirically-based model entitled "Continuity of Community Reintegration" (the CCR model) that acknowledges the emotional, social, and functional aspects of the personal recovery process of adolescents by considering the essential care providers, i.e., the family, community-based programs, schools, and clinics or hospitals. This model is based on a research project including a scoping review and qualitative data collected from 86 stakeholders involved in Amitim for Youth, the first community-based program for adolescents with mental health conditions in Israel. CONCLUSION:The model underscores that continuity of care across all the care providers is essential to optimize the personal recovery of these adolescents while emphasizing their agency, encouraging them to engage actively in decision-making, goal setting, and while guiding them towards reintegration into the community and personal recovery.

Future time perspective refers to our subjective perceptions of the future. These perspectives change across the lifespan, shaping our goals, and accordingly, our actions. Exploring future perspectives can support self-development while aging but may also evoke perspectives that are difficult to discuss. While the arts can provide a safe and creative environment for older adults to explore future time perspectives, studies in this field are scarce. The current qualitative study explored the future time perspectives of older adults as expressed through digital photocollage. This study was part of a larger project aimed at developing an online arts-based intervention for community-dwelling older adults. Twenty-four Italian and Israeli older adults aged 78–92 participated in a brief therapeutic online intervention integrating Dignity Therapy and digital photocollage. Visual and verbal data were analyzed using polytextual thematic analysis. Four themes emerged: three reflecting participants’ attitudes toward the future and one reflecting the evolution of future time perspectives during the creative process. The findings indicate that despite the short-term nature of the creative online intervention, and the complex topic at hand, participants expressed multiple future perspectives. The study also highlights the potential of digital and artistic methods to facilitate both the expression and the expansion of older adults’ future perspectives. These findings contribute to the growing literature on creative arts therapies in later life, demonstrating the potential of digital arts-based approaches in fostering meaningful engagement with future-oriented narratives among older adults.

This qualitative study examined Amitim for Youth, the first community-based program for social integration designed for adolescents with mental health conditions in Israel. The aim of this study was to better understand the stakeholders’ perspectives on the program and, in particular, the consumer’s subjective experiences. Semi-structured in-depth interviews, group interviews (focus groups), and information related to the program’s steering committee was collected. Eighty six interviewees from eight subgroups: (1) adolescents participating in the program, (2) their parents, (3) adolescents who withdrew from the program, (4) their parents, (5) the program coordinators, (6) the program’s volunteer youth supporters (mentors), (7) the referring mental health professionals and (8) members of the program’s inter-ministerial steering committee. The interviews were analyzed using a systematic reflexive thematic analysis that included six steps. A triangulation procedure compared the data collected by different methods and from the eight different information sources to strengthen the reliability of the findings. Three main themes emerged: adolescents taking agency and enhancing independence, strengthening positive identity and meaning-making through creative activity, and mentoring as a bridge to community belonging. With the support of the coordinators, adolescents with mental health conditions can achieve a sense of agency and independence, cultivate their talents, and promote personal recovery. The adolescents need mediation from the coordinators and mentors to bond with their peers and participate in structured activities that foster a sense of belonging and reintegration into the community.

Phototherapy is a therapeutic approach in which trained therapists use photography and photographic materials to facilitate psychological growth and therapeutic change. This qualitative study explores how professionals employ phototherapy with older women, focusing on their perspectives on creative processes related to the aging female body. Aging women often navigate the impact of gendered ageism - the intersection of ageism and gender bias - which contributes to shape their self-perceptions and body image. In Western societies, where youthfulness is highly valued, older women may experience internalized ageist stereotypes that influence their sense of self. This study seeks to understand how phototherapy can serve as a means of reflection, validation, and self-expression in the face of these challenges. To investigate this, 16 international therapists working with middle-aged and older women through phototherapy were interviewed. Using reflexive thematic analysis, four key themes were generated: (1) encountering the aging body in photographs: navigating ageism and self-ageism; (2) exploring the aging body through visual metaphors and symbols; (3) photographs as a space for visibility and validation; and (4) claiming agency through active engagement in photography. The findings provide insights into how phototherapy techniques can be used to support aging women in exploring and expressing their embodied self-representations. These insights will inform the development of an arts-based intervention designed to address the psychosocial needs of older Italian women, fostering self-acceptance and agency through narrative and phototherapy practices.

Phototherapy is a therapeutic approach in which trained therapists use photographs and photography to facilitate psychological growth and therapeutic change. This study explored how therapists apply phototherapy with older women, and focuses on techniques that address the aging female body. Because gendered ageism, i.e., the intersection of ageism and gender bias, shapes women’s embodied experiences of aging, this study examined the core processes and phototherapy techniques that creative arts therapists, psychologists, psychotherapists, and social workers implement with aging women. Sixteen international professionals working with aging women through phototherapy techniques were interviewed, and the resulting data were then analyzed through Reflexive Thematic Analysis. Four themes were generated: (1) photography as a medium for the visibility and recognition of the aging female body; (2) visual metaphors and symbols as methods to explore the aging body; (3) agency through photography engagement; and (4) confronting ageism in photographic representations of the aging body. Together, the findings highlight the potential of phototherapy to foster visibility, recognition, and agency in relation to the embodied experiences of older women. By emphasizing the continuum of clients’ responses, the findings highlight the importance of client-led therapeutic approaches. When thoughtfully adapted to individual needs, phototherapy can offer mental health practitioners a valuable tool to support older women in exploring identity and embodiment in later life.

The social arts (SA) are a subfield of the participatory arts that integrate the arts and social practices. SA are defined as art created by socially engaged professionals, including artists, creative arts therapists, social workers, and/or others who collaborate with nonprofessionals. SA artists aim to raise awareness, kindle empathy, and instill hope while urging action. SA works are often created to increase public awareness, influence government policy, and process trauma and grief. This qualitative study describes and contextualizes eight SA works made in Israel in response to the Hamas terrorist attack on October 7th, 2023, and the hostage crisis in Gaza during the Israel-Hamas war. The study also sought to explore the underlying meanings of these works through semiotic analysis. The semiotic analysis revealed recurring themes: the use of signifiers (for example, teddy bears and the figure of a woman) to signify innocence and vulnerability, unoccupied furniture (empty beds, dinner tables awaiting guests) to signify loss, and the use of yellow to signify solidarity and support. The SA works evoked grief, longing, and horror, but also camaraderie and resilience, thus reflecting the range of human experiences during the war. Future research recommendations include exploring the long-term impact of SA and, in particular, its role in encouraging healing, resilience, and hope within the context of conflict and loss.

Future time perspective is a concept that refers to individuals’ subjective perceptions of the future. These perceptions influence people’s actions and goals and change throughout the lifespan. Addressing the future can promote self-development while aging but can also raise perspectives that are difficult to discuss. While the arts can provide a safe and creative environment for older adults to explore future time perspectives, studies in this field are scarce. This qualitative study explored the future time perspectives of older adults as expressed through digital photocollage. It is part of a larger project aimed at developing an online arts-based intervention for community dwelling older adults. Twenty-four Italian and Israeli adults aged 78-92 participated in a brief therapeutic online intervention integrating Dignity Therapy and digital photocollage. Visual and verbal data were analyzed in an inductive framework, through polytextual thematic analysis (Gleeson, 2020). Four themes were generated. The first three reflected participants’ attitudes and wishes for the future. The fourth theme reflected the evolution of future time perspectives during the creative process. Findings indicated that despite the short-term nature of the creative intervention, and the complex topic at hand, participants expressed multiple future time perspectives. The findings highlight how digital and artistic techniques promote the expression and expansion of older adults’ future time perspectives.

Implementing Evidence-Based Creative Arts Therapies in Facilities catering for Older Adults Daphna M. Kalir, Shoshi Keisari, Hod Orkibi, Rim Abu-Nashef, Neta Singer Abstract Creative Arts Therapies (CATs) utilize various art forms to foster psychological growth, particularly among older adults. The current study explored the implementation patterns of CATs in facilities that cater to older adults’ needs in Israel, and especially the barriers and facilitating factors of the implementation processes. Our research consisted of two studies: a qualitative study aimed to identify barriers and facilitators to CATs implementation, and a quantitative study that included a survey to characterize CATs implementation in Israel. The qualitative sample (n = 18) included managers, social workers, CATs therapists, and older adult clients in community settings. The quantitative study distributed a structured survey to 62 CAT therapists treating older adults, analyzing therapist demographics, practice settings, and key variables. Subgroup comparisons highlighted differences in training, supervision, and work environments, offering a comprehensive view of CATs implementation. Barriers to CATs implementation included a lack of legally established standards, insufficient funding, preconceptions about CATs and mental health among older adults, and decision makers, and limited awareness of the field. Facilitating factors included prior familiarity of managers and policymakers with CATs, recognition of their effectiveness, therapists’ strong motivation, flexible intervention strategies, and implementation frameworks. Findings underscore the need to raise awareness of CATs’ benefits and ensure accessible mental health care for community-dwelling older adults. Addressing misconceptions about CATs and mental health treatment is essential for improving attitudes among older adults and policymakers.

In psychodrama, spontaneity is a state of readiness that propels individuals to respond in new and appropriate ways, serving as the vehicle through which creativity finds expression and acts as a catalyst for creative-adaptive responses to life changes and unexpected challenges. Given the limitations of previous attempts to measure spontaneity, this research, consisting of three consecutive studies grounded in psychodrama theory, aimed to develop and validate the State Spontaneity Scale in English. Study 1 defined the psychological construct of spontaneity by generating a pool of items based on responses from 108 international psychodrama experts. Study 2 identified the most suitable items reflecting the construct of spontaneity based on 13 experts' and authors' evaluations of the responses. Study 3 (N = 240) supported a 12-item State Spontaneity Scale measurement model, which showed that spontaneity could be measured as a latent construct underlying four interrelated factors: dynamic presence, readiness, intuition, and openness. The State Spontaneity Scale presented strong internal consistency reliability, and its correlations with other measures (spontaneity, state anxiety, and creative adaptability) pointed to convergent and discriminant validity. The discussion interprets the findings in light of psychodrama theory and empirical research. In addition, associations between spontaneity, theater, creativity, and divergent thinking are offered to encourage future studies.

The putative associations between creative adaptability and the experience of emotional well-being (i.e., a positivity ratio of more positive than negative emotions) was investigated during the COVID-19 pandemic outbreak with a sample of 1,432 adults from four countries: Israel (n = 310), United States (n = 312), Italy (n = 378), and China (n = 569). Country differences and a mediation model for creative adaptability predicting emotional well-being through creative self-efficacy, resilient coping, and emotion regulation (reappraisal and suppression) were examined. The findings point to slight differences in countries, which are potentially due not only to the culture but also to the phase of the pandemic. More consistently, creative adaptability was positively associated with creative self-efficacy, resilient coping, and reappraisal emotion regulation in all countries. Regarding mediation, in the Israeli, Italian, and Chinese samples, creative adaptability was positively related to resilient coping, which was positively related to emotional well-being. Similar relations were found for creative self-efficacy as a mediator in the United States and Chinese samples. In the Chinese sample, creative adaptability was positively associated with suppression, which was negatively associated with emotional well-being. These results are suggestive of the role of creative adaptability in dealing with the emotional burden associated with the COVID-19 crisis.

The act of play has long been recognized as a fundamental aspect of human development. Playfulness, in turn, is considered a variable reflecting individual differences regarding the disposition to engage in play. To gain insight into playfulness’s potential contribution to health and well-being, this paper will explore its role during times of extreme adversity, proposing a theoretical model to understand playfulness as a coping mechanism in such conditions. Our Playfulness as a Coping Strategy model suggests that playfulness comprises various dimensions that serve as intrinsic resources for navigating adversity. In this context, we refer to playfulness as a self-initiated state, whereby individuals reclaim their autonomy to enter a space that opposes or contradicts the extremely adverse condition they are in. The model frames the use of playfulness in extremely adverse conditions, and demonstrates the model with two case illustrations of videos from soldiers in war, both from Ukraine and Israel. By doing that, we shed light on how playfulness can be cultivated as a protective factor promoting psychological adaptation. Furthermore, we outline future directions for research on playfulness as a change factor (i.e., active ingredient) in the creative arts therapies and other interventions, paving the way for elucidating its role in fostering well-being and health.

Older adults with constricted life-space mobility (limited range of movement and activity within one's environment) face an increased risk of social isolation and poor psychological well-being. Developing accessible interventions tailored for this population is crucial. This randomized controlled trial examined the effect of a 12-week tele-drama therapy intervention on psychological well-being and the relationships between in-session therapeutic change factors and outcomes. A total of 111 older adults, aged 63-102, with constricted life-space mobility participated in this study, delivered via Uniper Care, a social club aimed at promoting active aging through accessible technology designed with and for older adults (ClinicalTrials.gov: NCT06419881). The intervention effectively improved social connectedness, personal growth, and general well-being, while also decreasing depressive symptoms. Individual differences influenced participants' experiences of the therapeutic and creative process. These findings can help refine the theories and practice of tele-drama therapy interventions.